Pyelonephritis

pyelonephritis: see nephritis.

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pyelonephritis

Infection (usually bacterial) and inflammation of kidney tissue and the renal pelvis. Acute pyelonephritis is usually localized and may have no apparent cause. Symptoms include fever, chills, lower-back pain, and bacteria and white blood cells in the urine. Treatment with antibiotics requires one to three weeks. Scar tissue forms, but kidney function is usually not impaired. Chronic pyelonephritis results from repeated bacterial infections, which may have no symptoms but destroy more and more tissue over years. If it is diagnosed before too much function is lost, surgery may help, but uremia, severe infections, and heart and blood-vessel disorders can lead to death. Dialysis or kidney transplant sometimes prolongs life.

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pyelonephritis [¦pī·ə·lō·ne′frīd·əs]

(medicine)

The disease process resulting from the effects of infections of the parenchyma and the pelvis of the kidney. Also known as interstitial nephritis.

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Pyelonephritis 

an inflammation of the calyxes, pelvises, and parenchyma of the kidneys caused by the colon bacillus, staphylococcus, Pseudomonas aeruginosa, Proteus, and by other microorganisms. Primary, acute or chronic, and unilateral or bilateral forms of pyelonephritis are distinguished from secondary pyelonephritis, which is preceded by other diseases of the kidney and urinary tract. The morphologic changes associated with the disease take the form of clusters of cellular infiltrates. In chronic pyelonephritis, the kidney surface exhibits multiple cicatricial retractions. The cortical layer is thin and uneven.

Acute pyelonephritis often begins with fever, chills, and pain in the lumbar region. Urination is painful and frequent, and there may be headaches, nausea, and vomiting. Nitrogenous residues may increase in the blood in the early stages. The urine contains pus, red blood cells, albumin, and numerous bacteria, more than 100,000 per ml of urine. Treatment consists of antibacterial therapy with sulfanilamides, nitrofurans, and antibiotics. During the stage of fever, the intake of protein should be limited. Later the diet may be normal, with a copious intake of fluids, application of heat to the lumbar region, and antispasmodics.

The presence of chronic pyelonephritis is often revealed during urinalysis or the taking of blood pressure. The patient may complain of general weakness, headache, lack of appetite, pain in the lumbar region, and increased frequency of urination. The skin is pale and dry. The disease’s progress is bilateral. The urine’s specific gravity decreases and hypertension frequently develops, as does renal insufficiency. Diagnostic methods include urinalysis and examination of the renal functions, roentgenography, the use of radioisotopes, and occasionally biopsy of the kidneys. Treatment consists of prolonged antibacterial therapy with such drugs as nitrofurans, sulfanilamides, antibiotics, and NegGram. In the case of hypertension, hypotensive drugs are prescribed and the impaired urine flow is normalized. If such contraindications as renal insufficiency, obstruction of the urinary tract, and marked hypertension are absent, treatment in the Truskavets, Essentuki, Zheleznovodsk, or Sairme sanatoriums may be prescribed.

REFERENCES

Pytel’, A. Ia., and S. D. Goligorskii. Pielonefrit. Moscow, 1961.
Ratner, N. A. Bolezni pochek i gipertoniia, 2nd ed. Moscow, 1971.

F. M. PALEEVA